Cerebral Blood Flow Correlates of Apathy in Alzheimer Disease

Craig, Ann H.; Cummings, Jeffrey L.; Fairbanks, Lynn A.; Itti, Laurent; Miller, Bruce L.; Li, Jenny; Mena, Ismaël

doi:10.1001/archneur.1996.00550110056012

Cited by 204 publications

(157 citation statements)

References 27 publications

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“…This conclusion is supported by previous associations between apathy and dysfunction in prefrontal and anterior temporal brain regions (Okada et al, 1997;Craig et al, 1996). Cerebrovascular disease has previously been linked to depression in several studies of individuals with dementia (e.g., O'Brien et al, 2000;Hargrave et al, 2000).…”

Section: Discussionsupporting

confidence: 68%

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Treiber

Corcoran

Steinberg

et al. 2008

IPG

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Objective-To examine, in an exploratory analysis, the association between vascular conditions and the occurrence of neuropsychiatric symptoms (NPS) in a population-based sample of incident Alzheimer's disease (AD).Methods-The sample consisted of 254 participants, identified through two waves of assessment. NPS were assessed using the Neuropsychiatric Inventory. Prior to the onset of AD, data regarding a history of stroke, hypertension, hyperlipidemia, heart attack or CABG, and diabetes were recorded. Logistic regression procedures were used to examine the relationship of each vascular condition to individual neuropsychiatric symptoms. Covariates considered were age, gender, education, APOE genotype, dementia severity, and overall health status.Results-One or more NPS were observed in 51.0% of participants. Depression was most common (25.8%), followed by apathy (18.6%), and irritability (17.7%). Least common were elation (0.8%), hallucinations (5.6%), and disinhibition (6.0%). Stroke prior to the onset of AD was associated with increased risk of delusions (OR=4.76, p=0.02), depression (OR=3.87, p=0.03), and apathy (OR=4.48, p=0.02). Hypertension was associated with increased risk of delusions (OR=2.34, p=0.02), anxiety (OR=4.10, p=0.002), and agitation/aggression (OR=2.82, p=0.01). No associations were observed between NPS and diabetes, hyperlipidemia, heart attack or CABG, or overall health. Conclusions-Resultssuggest that a history of stroke and hypertension increase the risk of specific NPS in patients with AD. These conditions may disrupt neural circuitry in brain areas involved in CORRESPONDING AUTHOR:

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Section: Discussionsupporting

confidence: 68%

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Treiber

Corcoran

Steinberg

et al. 2008

IPG

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“…Apathy is the most frequent and severe behavioral symptom in both MCI [1] and Alzheimer's disease (AD) [2,3] and may characterize a subset of MCI subjects at higher risk of progression to dementia [4][5][6][7]. The functional neuroanatomy of apathy has been studied primarily in AD patients, where it was found that bilateral frontal, temporal, and cingulate area hypoperfusion and hypometabolism are associated with apathy severity [8][9][10][11][12]. Several structural neuroimaging studies also demonstrated an association between apathy and loss of integrity of frontal regions in AD [13,14].…”

Section: Introductionmentioning

confidence: 99%

White Matter Microstructure and Apathy Level in Amnestic Mild Cognitive Impairment

Cacciari

Moraschi

Paola

et al. 2010

JAD

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Abstract. In this study, we assessed white matter microstructural deficit correlates of apathy level in 20 patients with amnestic mild cognitive impairment by means of diffusion tensor imaging. Mean diffusivity correlated positively with apathy level in the right temporal portion of the uncinate, middle longitudinal and inferior longitudinal fasciculi and in the parathalamic white matter, the fornix and the posterior cingulum of the right hemisphere. Fractional anisotropy results confirmed evidence of disconnection associated with apathy in all white matter areas except the middle longitudinal fasciculus. These results support the view that alterations in the neural mechanisms underlying apathy level occur in the early phase of degenerative dementias.

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“…Its prevalence depends on the type of population studied, the diagnostic criteria and the type or severity of dementia. when diagnosed with the Neuropsychiatric Inventory (NPI) 15 in outpatient settings, apathy prevalence ranged from 55% 16 to 80% 17 , and from 36% 12 to 53.3% 18 in community based samples of Ad patients. van reekum and coworkers' pooled analysis found a point prevalence of 60.3% in outpatients with Ad 19 .…”

mentioning

confidence: 99%

Neurobiology of apathy in Alzheimer's disease

Guimarães

Lévy²,

Teixeira

et al. 2008

Arq. Neuro-Psiquiatr.

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-Apathy is considered the most frequent neuropsychiatric disturbance in dementia and its outcome is generally deleterious. Apathy can be related to a dysfunction of the anatomical-system that supports the generation of voluntary actions, namely the prefrontal cortex and/or the prefrontal-subcortical circuits. In Alzheimer's disease, pathological and neuroimaging data indicate that apathy is likely due to a dysfunction of the medial prefrontal cortex. Accordingly, in this review article, we propose a pathophysiological model to explain apathetic behavior in Alzheimer's disease, combining data from neuroimaging, neuropathology and experimental research on the role of orbito-frontal cortex, anterior cingulate cortex, basal ganglia and dopamine in decision-making neurobiology.Key words: apathy, Alzheimer's disease, decision-making, orbito-frontal cortex, anterior cingulate cortex, basal ganglia, dopamine. Neurobiologia da apatia na doença de alzheimerResumo -Apatia é considerada a alteração neuropsiquiátrica mais freqüente nas demências e suas conseqüências são habitualmente deletérias. Apatia pode ser relacionada à disfunção do sistema anatômico responsável pela geração de ações voluntárias, conhecido com córtex pré-frontal e/ou circuitos pré-frontais-subcorticais. Na doença de Alzheimer, evidências neuropatológicas e de neuroimagem funcional indicam que a apatia é provavelmente decorrente da disfunção do córtex pré-frontal medial. Assim, neste artigo de revisão, apresentamos uma proposta de um modelo fisiopatológico para explicar o comportamento apático na doença de Alzheimer, combinando dados de neuropatologia, neuroimagem e experimentação animal sobre o papel do córtex órbito-frontal, cíngulo anterior, núcleos da base e dopamina na neurobiologia da tomada de decisão.PAlAvrAs-chAve: apatia, doença de Alzheimer, tomada de decisão, córtex órbito-frontal, córtex cingulado anterior, núcleos da base, dopamina.

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Cerebral Blood Flow Correlates of Apathy in Alzheimer Disease

Cited by 204 publications

References 27 publications

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study

White Matter Microstructure and Apathy Level in Amnestic Mild Cognitive Impairment

Neurobiology of apathy in Alzheimer's disease

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